Diagnostic methods for neuropathic pain

Risk of bias, particularly regarding the administration of the index and reference tests, should be taken into account in interpretation of the results. [...] Critical Appraisal of Individual Studies The included diagnostic studies were critically appraised using the QUADAS-2 checklist.20 Summary scores were not calculated for the included studies; rather, a review of the strengths and limitations of each included study were described and presented in tabular and graphical format. [...] Two studies used the same assessor or clinician to perform the reference and index tests.21,26 One study failed to blind the index assessor to the results of the reference test32 and for several studies blinding of assessors was unclear.6,25,28,30 Given the baseline subjectivity of these screening tools, lack of blinding may have opened these studies up to detection bias. [...] Observed differences in the performance of various tools may be attributable to the absence of clinical assessment components within the PD-Q and Neuropathic Pain Questionnaire tools, as well as differences in the approach to clinical assessment taken for the LANSS and DN4. [...] These findings must also be interpreted in the context of the limitations of the individual studies, factoring in risk of bias, applicability, and generalizability, which was limited in some cases.